Director, Health System Contracting @ CVS Caremark Corporation
Director, Practice Management Transformation @ Coastal Medical
Manager, Patient Centered Medical Home Training & Support @ Blue Cross Blue Shield of Rhode Island
Bachelors of Science @
University of Rhode Island
Health care professional with over 20 years leadership experience managing large business units responsible for operations, fiscal management, strategic planning and business development. Expertise in health plan customer service, provider relations and credentialing, claims and enrollment administration, health care contracting as well as IT software implementations and business integration. In depth knowledge and experience working with physicians
Health care professional with over 20 years leadership experience managing large business units responsible for operations, fiscal management, strategic planning and business development. Expertise in health plan customer service, provider relations and credentialing, claims and enrollment administration, health care contracting as well as IT software implementations and business integration. In depth knowledge and experience working with physicians and hospital leaders to implement innovative health system reform initiatives and programs in support of Accountable Care Organizations (ACOs) and the Patient Centered Medical Home (PCMH) Model of care delivery. Dedicated to transforming our health system through collaboration to achieve better health outcomes and efficiencies.
Director, Health System Contracting @ Develop strategic relationships with health systems including hospitals, ACO's and other integrated delivery system executives, physician leaders and physicians across the country.
Engage with health systems to execute collaborative contractual agreements that focus on improving quality outcomes and reduce medical costs through innovative pharmacy programs.
Execute collaboration agreements, maintain overall relationship with the health system and ensure contract is fully implemented. From May 2013 to Present (2 years 8 months) Director, Practice Management Transformation @ Responsible for planning, development and execution for Accountable Care Organization (ACO) program initiatives. Led clinical practice transformation work in partnership with physicians, and staff to adopt PCMH model of care, apply process improvement methods for system efficiencies and improve clinical and service quality. Managed EMR Training Team in support of ACO initiatives, Meaningful Use Incentives, NCQA PCMH recognition status and other quality performance outcomes targets. From January 2012 to September 2012 (9 months) Providence, Rhode Island AreaManager, Patient Centered Medical Home Training & Support @ Responsible for developing provider practice support strategy including conceptual training for successful implementation of Patient Centered Medical Home (PCMH) and Principle Care Centers (PCC) in physician practices or hospital settings and the design of technical training and support for maximizing the use of the electronic health record data to facilitate population and other health management strategies at the physician practice level. Leads the PCMH/PCC training program implementation and establishes the long-term business model objectives that align with the corporate IHM strategic goals. From September 2009 to January 2012 (2 years 5 months) Director, IT Business Solutions @ Business integration leader for multi-year $140M enterprise-wide legacy system replacement project responsible for program management, budget and execution. Accountable for managing several project work teams including change management, business process design, business requirements management, system design and configuration, training, project communications and system testing. From October 2007 to September 2009 (2 years) Corporate and Career Coach @ Independent consultant certified as a professional behavioral analyst (DISC) and values analyst providing leadership and career coaching services for all levels of management maximizing productivity and skill potential. From November 2006 to October 2007 (1 year) AVP, Customer & Provider Service Call Center Operations @ •Successfully managed $14M operating budget.
•Senior Leader responsible for the Customer & Provider Service Call Center operations and 220 employees.
Developed and executed strategic plan to incorporate standard operating procedures, budgets, performance management program and mangement infrastructure to support 500+k members and 8k providers.
Secured funding to implement several systems to increase automation and reduce expenses by 1M.
• Attained JD Powers Award for Outstanding Customer Experience in 2006.
Established participating physician network in RI and Southeastern MA for HMO subsidiary.
•Negotiated cost effective contracts with physicians and other providers to reach profitability for a 10,000 member Medicaid HMO in two years.
•Developed entire physician and provider credentialing program to successfully meet standards for NCQA accreditation and regulatory compliance.
•Managed HMO Claims and Enrollment Departments delivering timely service and met CMS performance standards.
•Managed Grievance and Appeals Department responsible for responding to member and provider complaints and appeals in accordance with Federal and State regulatory guidelines From February 1996 to October 2006 (10 years 9 months)
Master of Science, Health Services Administration @ Salve Regina University From 1988 to 1992 Bachelors of Science, Consumer Affairs @ University of Rhode Island From 1983 to 1987 Stephanie Ledoux is skilled in: Process Improvement, Change Management, Performance Management, Employee Engagement, Call Center, Provider Relations, Healthcare, Managed Care, Health Insurance, Healthcare Information Technology, Healthcare Management, HIPAA, Leadership Development, Hospitals, Performance Improvement
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